Troponin T, High-Sensitivity

Marker of myocardial injury. Aid in the rule in / rule out of acute coronary syndrome (ACS). Useful in monitoring and prognosis in patients with ACS.
Troponin T is one of three proteins of the troponin complex that regulates the calcium mediated interaction of actin and myosin. Plasma levels of Trop T begin to rise within several hours after an acute myocardial infarction, with peak concentrations being reached in approximately 12-18 hours after infarction. Troponin T levels can remain elevated in plasma for 5 to 7 days before returning to normal. Because it is a marker of myocardial injury, Troponin T may be elevated in a number of cardiac conditions other than AMI, including unstable angina, congestive heart failure, end-stage renal disease, septic shock, hypertension, cardiomyopathy, myocarditis, pulmonary embolism, and tachyarrythmias.
The 99%ile of a normal population for this Trop T assay is 19 pg/mL. For patients who present with suspected ACS, a Trop T value > 19pg/mL with a rising pattern in serial samples is suggestive of ACS. Serial measurements are highly recommended for the diagnosis or exclusion of ACS. For rule in or rule out on an inpatient unit, samples drawn 3 to 4 hours apart showing a difference or delta value of greater than 6 pg/mL is considered consistent with acute myocardial injury. A decrease in Trop T over time can indicate an acute injury that occurred days ago, but in general is less specific for ACS and more often associated with non-ACS conditions. Chronic conditions that can produce an elevation of Trop T will rarely show a significant delta over time intervals of 2 to 6 hours.
Clearance of Troponin T can be prolonged in patients with a decreased eGFR.
For more information, please view the educational material:
High Sensitivity Troponin T Education